中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
Chinese Journal of Plastic Surgery
2015年
5期
324-326
,共3页
双侧唇裂%鼻唇畸形%同期修复
雙側脣裂%鼻脣畸形%同期脩複
쌍측진렬%비진기형%동기수복
Bilateral cleft lip%Cleft lip and nasal deformity%Synchronous correction
目的 探讨双侧唇裂鼻唇畸形进行同期修复的手术方法,并评价其效果.方法 本组共29例,均为完全性双侧唇裂,灵活应用Mulliken手术方法进行鼻唇畸形的同期修复手术,根据亚裔人种特点设计,人中瓣长度6～7 mm,鼻小柱与唇交界处宽度3～4 mm,两侧唇峰间距为4～5 mm.于人中瓣两侧划出点状的皮瓣,去除表皮后推进侧方皮瓣皮下,形成人中嵴.在侧方唇瓣定出两侧唇峰点,向上至鼻底划线.广泛分离两侧唇瓣,再造弓背曲线和唇珠.充分分离并重新缝合定位鼻翼软骨,抬高鼻尖,形成鼻底,延长鼻小柱,缩窄鼻宽度.结果 术后患者伤口均为一期愈合,术后随访6个月至6年,所有患者上唇瘢痕均不明显,人中形态自然,人中嵴存在,红唇形态满意,唇珠存在,无明显红唇凹陷及口哨畸形.患者鼻小柱无明显短缩,鼻翼及鼻尖塌陷明显改善,前颌骨明显后退.结论 灵活应用Mulliken手术方法并结合亚裔人特点进行双侧唇裂鼻唇畸形的同期修复,术后效果满意.
目的 探討雙側脣裂鼻脣畸形進行同期脩複的手術方法,併評價其效果.方法 本組共29例,均為完全性雙側脣裂,靈活應用Mulliken手術方法進行鼻脣畸形的同期脩複手術,根據亞裔人種特點設計,人中瓣長度6～7 mm,鼻小柱與脣交界處寬度3～4 mm,兩側脣峰間距為4～5 mm.于人中瓣兩側劃齣點狀的皮瓣,去除錶皮後推進側方皮瓣皮下,形成人中嵴.在側方脣瓣定齣兩側脣峰點,嚮上至鼻底劃線.廣汎分離兩側脣瓣,再造弓揹麯線和脣珠.充分分離併重新縫閤定位鼻翼軟骨,抬高鼻尖,形成鼻底,延長鼻小柱,縮窄鼻寬度.結果 術後患者傷口均為一期愈閤,術後隨訪6箇月至6年,所有患者上脣瘢痕均不明顯,人中形態自然,人中嵴存在,紅脣形態滿意,脣珠存在,無明顯紅脣凹陷及口哨畸形.患者鼻小柱無明顯短縮,鼻翼及鼻尖塌陷明顯改善,前頜骨明顯後退.結論 靈活應用Mulliken手術方法併結閤亞裔人特點進行雙側脣裂鼻脣畸形的同期脩複,術後效果滿意.
목적 탐토쌍측진렬비진기형진행동기수복적수술방법,병평개기효과.방법 본조공29례,균위완전성쌍측진렬,령활응용Mulliken수술방법진행비진기형적동기수복수술,근거아예인충특점설계,인중판장도6～7 mm,비소주여진교계처관도3～4 mm,량측진봉간거위4～5 mm.우인중판량측화출점상적피판,거제표피후추진측방피판피하,형성인중척.재측방진판정출량측진봉점,향상지비저화선.엄범분리량측진판,재조궁배곡선화진주.충분분리병중신봉합정위비익연골,태고비첨,형성비저,연장비소주,축착비관도.결과 술후환자상구균위일기유합,술후수방6개월지6년,소유환자상진반흔균불명현,인중형태자연,인중척존재,홍진형태만의,진주존재,무명현홍진요함급구초기형.환자비소주무명현단축,비익급비첨탑함명현개선,전합골명현후퇴.결론 령활응용Mulliken수술방법병결합아예인특점진행쌍측진렬비진기형적동기수복,술후효과만의.
Objective To investigate the technique and its therapeutic effect of synchronous correction of lip and nasal deformity in complete bilateral cleft lip.Methods 29 patients with complete bilateral cleft lip underwent synchronous correction of lip and nasal deformity with the modified Mulliken method for Asians.The philtral flap was 6-7 mm in length,and 3-4 mm in width at the collumellarlabial junction.The distance between the peaks of cupid' s bow was 4-5 mm.The bilateral edge of philtral flap was de-epithelialized and advanced to form philtrum column.The lateral lip was advanced to the medial site,and the central vermilion tubercle was constructed with the bilateral vermilion-mucosal flap.Through the alar rim incision,the displaced cartilage was dissected and repositioned to raise the nasal tip.The follow-up period was 6 months to 6 years.Results Satisfactory results were achieved in all patients.The reconstructed upper lip had invisible scar with natural philtrum and column.The vermilion had good appearance with tubercle.The length of nasal column was not decreased and depression of nasal tip and alar was greatly improved.Conclusions Our modified Mulliken method is effective in synchronous correction of lip and nasal deformity in bilateral cleft lip.
